POS1555-HPR EVALUATION OF CONVERSATIONS IN MOTION: A PROGRAM DESIGNED TO IMPROVE PATIENT-PROVIDER COMMUNICATION IN THE CARE OF RHEUMATOID ARTHRITIS
Authors: E. Nikiphorou, S. Péloquin, M. Augustyniak, A. Negoescu, D. Walker, F. Haq, P. Lazure, S. Murray
Journal: Annals of the Rheumatic Diseases (2022)

Background Previous studies have found a need for improvement in communications between healthcare professionals (HCPs) and patients with rheumatoid arthritis (RA), especially in relation to shared-decision making (SDM), management of expectations, and goal-setting. 1-2 Conversations in Motion (CIM) is an educational program, consisting of four modules, that teaches HCPs how to use validated communication techniques to improve the quality and efficiency of their consultations with RA patients. Objectives This pilot study assessed the impact of CIM deployed in the United Kingdom (UK) on HCPs’ knowledge, skills, confidence, beliefs, and performance using validated communication techniques in interactions with RA patients. Methods A longitudinal mixed-methods study, consisting of three surveys (pre/before the program, 2-3 weeks post, and 5-6 months follow-up) and semi-structured interviews (4-6 weeks post) was used to evaluate CIM based on the outcome model by Moore et al. 3 Surveys assessed outcomes via multiple choice or 11-point rating scale questions (0-none, 10-extreme). Participants included UK rheumatology physicians, nurses, and allied HCPs, all of whom had a minimum yearly caseload of 10 RA patients and participated in CIM between September and October 2020. Survey data was descriptively analysed in SPSS by comparing pre with post and pre with follow-up (matched samples). Interviews were thematically analysed using NVivo. Results Almost half (15/34) of registrants completed all four CIM modules. Of those, 53% (n=8) completed pre and post surveys; 33% (n=5) pre and follow-up surveys; and 27% (n=4) completed interviews. Post surveys showed greater knowledge for strategies to build trust and empathy with RA patients and practice efficiency than at pre (Figure 1). A decrease in helplessness was noted for dealing with a patient who is nonadherent (pre=3.9/10; post=1.6/10). Interviewees described CIM as “thought provoking” and reported improvement in their ability and confidence to use patient’s own stories and words as a strategy to build trust and empathy (n=4). Post and follow-up surveys showed changes in skills and confidence were more pronounced for practice efficiency and discussing nonadherence (Table 1). At follow-up, most participants reported practicing at least one technique to build trust and empathy with patients (80%, 4/5), save time (100%, 5/5), engage in SDM, or discuss nonadherence (60%, 3/5). Table 1. Changes in skill and confidence post-CIM Matched respondents (n=8) Matched respondents (n=5) Survey item Pre Post Δ Pre Follow-up Δ Skill Assisting patients in the conceptualization of treatment pros and cons 5.6 7.1 +15% 5.4 6.4 +10% Listening to and understanding patients’ emotions, expectations, and personal needs 6.6 8.1 +15% 7.0 8.2 +18% Simplifying complex terminology related to RA 5.4 7.8 +24% 5.4 7.2 +16% Discussing reasons for nonadherence 5.4 7.8 +24% 4.2 6.4 +22% Confidence Engaging in shared decision making 6.1 7.9 +18% 5.0 6.2 +12% Building trust and empathy via telemedicine 5.9 6.9 +10% 5.0 6.0 +10% Addressing patient concerns in limited consultation 5.2 6.6 +14% 4.0 5.6 +16% Support patients through treatment adherence 6.0 7.5 +15% 4.0 6.2 +22% Table description : All items were rated on an 11-point scale (0-none, 10-extreme). The matched sample of participants who completed the pre and 2-3 weeks post-CIM survey was not the same as the one who completed the pre and 5-6 months follow-up survey. Change (Δ) was measured as the percent difference between means. Conclusion This pilot evaluation suggests that CIM has a measurable impact on HCPs’ learning and use of techniques that can enhance communication and collaboration with RA patients. Future studies should validate CIM impact in a larger sample size and/or by evaluating patients’ perspective on observed changes in their communication and collaboration with HCPs. References [1]Strand V et al. J Rheumatol 2015;42;2046-54. [2]Murray S et al. BMJ Open 11:e043960 [3]Moore Jr DE et al. J Contin Education Health Prof 2009;29(1):1-15. Acknowledgements The authors thank all participants in this study and acknowledge the contributions and support of Olivier Jacob, Senior Project Manager, AXDEV Group Inc. Disclosure of Interests Elena Nikiphorou Speakers bureau: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Eli Lilly, Grant/research support from: Pfizer and Eli Lilly, Sophie Péloquin: None declared, Monica Augustyniak: None declared, Andra Negoescu Speakers bureau: Eli Lilly, Bristol Myers Squibb, Galapagos, Abbvie, David Walker Speakers bureau: Eli Lilly, Galapagos, Consultant of: Galapagos, Gilead Sciences, Grant/research support from: Gilead Sciences, Fasiha Haq Shareholder of: Eli Lilly, Employee of: Eli Lilly, Patrice Lazure: None declared, Suzanne Murray: None declared